摘要
目的:探讨乌司他丁对脓毒症患者可溶性髓样细胞触发受体-1(sTREM-1)表达的影响。方法:选择60例确诊脓毒症的患者随机分为乌司他丁治疗组和常规治疗对照组,各30例。乌司他丁治疗组在常规治疗的基础上,加用乌司他丁20万单位/次静脉注射,2次/日连续10 d,分别于治疗前,治疗前第3、7和10日时取两组患者静脉血,采用ELISA法检测血清sTREM-1浓度,采用免疫比浊法检测CRP浓度。观察两组患者APACHEⅢ评分变化,并记录治疗后3、7、10和28 d时两组患者生存或死亡情况。检测30例健康志愿者的血清sTREM-1和CRP浓度作为正常对照组。结果:治疗前两组血清sTREM-1和CRP浓度显著高于健康对照组(P<0.05),但两组患者血清sTREM-1和CRP浓度比较差异无统计学意义(P>0.05)。治疗3、7、10 d两组血清sTREM-1和CRP浓度较治疗前逐步下降(P<0.05)。乌司他丁治疗组较常规治疗对照组血清sTREM-1和CRP浓度下降更显著(P<0.05)。APACHEⅢ评分降低更明显(P<0.05)。结论:乌司他丁可降低脓毒症患者血清sTREM-1和CRP水平,减轻脓毒症炎症反应强度,减少MODS的发生,从而缓解脓毒症临床症状,改善预后。
Objective： To investigate the clinical effects of ulinastain on Soluble Triggering Receptor Expressed on Myeloid Cells-1 （sTREM-1） expression in septic patients. Methods： Sixty patients with sepsis were divided randomly into two groups ： classical treatment group with regular therapy and the other plus ulinastain 200kU iv bid for 10 days and 30 healthy individuals as control group group was classical treatment The concentration of sTREM- 1 in plasma was measured by enzyme-linked immunosorbent assay and the level of serum CRP was detected by spectrophotometer in all patients. The acute physiology and chronic health evaluation /~ scoring system was applied to assess the severity of sepsis at the 3rd, 7th and 10th days after treatment. The survival and dead patients in two sepsis groups were observed. Results： The plasma concentration of sTREM-1 and CRP are significantly higher in septic patients than those in the control group before treatment （P 〈 0. 05 ）, and there was no difference between patients of the two groups （P 〉0.05 ）. At the 3rd, 7th and 10th days after treatment, the serum levels of sTREM- 1 and CRP decreased gradually in the two groups （P 〈 0. 05）. In the ulinastain treatment group, the concentration of sTREM-1 and CRP and APACHE 111 scoring were much lower than the routine treatment group （P 〈 0. 05）. The mortality at 28th day decreased significantly in the ulinastain treatment group （ P 〈 0. 05 ）. Conclusion： The treat- ment with ulinastain could reduce the serum level of sTREM-1 and CRP, alleviate the inflammatory reaction and decrease the occurrence of MODS in septic patients, so as to relieve the clinical symptoms and improve the prognosis of sepsis.
出处
《新医学》
2012年第10期731-735,共5页
Journal of New Medicine
基金
2011年中山大学青年教师培育基金(294002)
广东省科技计划基金(2010B080701085)
